VITAL RECORDS SEARCH APPLICATION

Dear____________________________________________ Date: ________________________

In order to process your request for a copy of vital statistics records, please provide us with the applicable information below so that we may provide you with faster service.

The fees for State certified copies of vital records is $10.00 for the first copy and $.5.00 for each additional copy of the same record. The Town also charges a $3.00 per name, per event search of records whether or not a record is located. This $3.00 fee includes a non-certified photocopy of the record if found. This fee must be paid before copies can be provided. Checks should be made payable to The Town of Bradley and returned, with this completed form and a self-addressed, stamped large manila envelope to:

Town of Bradley

Attn: Town Clerk

PO Box 517

Bradley, ME 04411

Thank You.

FOR MARRIAGE INFORMATION

Date of Marriage __________________________________________________

Full Name of Groom __________________________________________________

Bride’s Full Maiden Name __________________________________________________

FOR BIRTH INFORMATION

Date of Birth __________________________________________________

Name of Child __________________________________________________

Father’s Name __________________________________________________

Mother’s Maiden Name __________________________________________________

Relationship to Person Born to

Person requesting: __________________________________________________

FOR DEATH INFORMATION

Date of Death __________________________________________________

Name of Deceased __________________________________________________

Place of Burial __________________________________________________

Relationship to Deceased __________________________________________________

Signature & Printed Name of Person Requesting Search_________________________________________

Effective 5/1/2003, our policy for obtaining copies of vital statistics for genealogy purposes is as follows:

The following fees apply when conducting searches of our vital records:

$3.00 per name, per event, search of records, whether or not a record is located

(Includes a non-certified copy of the record if found). Photocopy labeled "not

for legal purposes".

$7.00 certified copy of a vital record. $3.00 for each additional certified copy of the same certificate ordered at the same time., in addition to the $3.00 per one, per event, search fee.

Please enclose with your request a check made payable to the Town of Bradley, a self-addressed stamped envelope and mail to:

Town Clerk

PO box 517

Bradley, ME 04411

***Vital Application For Record Search is on Back.***

***See "Vital Records Search Application"***